Neuro Surgery

Help! I'm stumbling my way through Neuro surgery and I have been having a hard time coding some of the surgeries. Does anyone out there do coding/billing for Neuro surgery?? Have any suggestions on resources for Neuro?

I work with two Trauma surgeons and they have been helpful and patient but I don't always know if the information they are giving me is correct. My main issue is coding craniotomy/craniectomy.

I, too, work for Neurosurgeons. You will find many spine/crani questions under the Orthopedic forum. As for additional help, have you tried these audiowebinars (link below)? They provide fee CEU's and a wealth of free information. There are others on this forum that are able to answer your questions. Now, Medtronic does not conduct crani seminars but again, if you post the question here, I'm sure someone can probably help you. Do you have a Neurosurgery Coding Companion? The publisher is Ingenix. I do find it useful. You're not alone so post away....

I have a coding compaion and an AANS guide to coding. I have minimal experience with neuro and I find myself a little lost. I am attending the conference in Vegas and am attending the spinal coding seminar but I get hung up on the craniotomies more.

I have a Dr that performed a Left Frontoparietal Craniotomy, Evacuation and removal of Chronic Hematoma, Stripping of membranes and duraplasy using temporalis fascia and Duragen.

What I'm confused about is the stripping of the membranes. When reading the Op report the Dr states "A very large area measuring about 8-9 cm of membrane with pockets of subdural and everything inside were carefully and bluntly dissected away using cottonoid and this was sent as a single specimen. The remainder of the subdural hematoma had similar characteristics and it had to be removed at the level of the tip of the frontal lobe, superior part of the convexity of the frontal lobe and tip of the temporal lobe."

I am having a hard time finding a code for this. Nothing specifically states stripping of the membranes etc...

My experience is mainly in Ortho and General. Neuro seems like a whole different world to me! I'm sure one I view some webinars I will feel a bit more comfortable but until then...

I have been under the impression that membrane stripping was inclusive to the primary procedure. Typically, when evacuating chronic hematoma's, the surgeons are expecting to find some exposed membrane. But...I did check with one of my providers, to be sure, and he agreed.

Thank you! I was going in this direct but my provider kept insisting that there was a new code for this that was introduced this year. I have 2009 books and I couldn't find it anywhere so I was starting to think that maybe I was over looking something.

I am running into that all the time that's why I like to have access to sites and coding journals so I have the back up. It has come in handy not just to help educate my docs but also to fight denials.

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